Permit A CITY OF TIGARD SITE WORK .
4 DEVELOPMENT SERVICES PERMIT
A PERMIT # • SIT98 -0032
13125 SW HaII Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 03 / 11 / 99
PARCEL: 2S102BC —THP01
SITE ADDRESS...: 12765 SW WATKINS AVE
SUBDIVISION THOMPSON PARTITION ZONING: R -4.5
BLOCK LOT :001 JURISDICTION: TIG
CLASS OF WORK..:NEW : PAVING? • N RESO. NO.:
TYPE OF USE -SF . GRADING? • Y VALUE...$: 18000
EXCV VOLUME: 0 cy LANDSCAPING? • N
FILL VOLUME: 0 cy SITE PREP? • Y
ENG FILL? N STORM DRAINS ?...: Y
SOILS RPT READ ?: N IMPERV SURFACE: 0 sf
•
Remarks : Site and grading permit for minor land partition
Owner: FEES
DAN THOMPSON type amount by date recpt
12765 SW WATKINS PRMT $ 128.50 GEO 03/11/99 99- 313610
TIGARD OR 97223 PLCK $ 83.53 GEO 03/11/99 99- 313610
5PCT $ 6.43 GEO 03/11/99 99- 313610
Phone #: EROS $ 160.00 GEO 03/11/99 99- 313610
ERPU $ 52:00 GEO 03/11/99 99- 313610
Contractor: ERPC $ 52.00 GEO 03/11/99 99- 313610
CURTIS HAYS
23405 SW BOONES FERRY RD
TUALATIN OR 97062
Phone #: 682 -9353 $ 482.46 TOTAL
Reg #..:. 113286
REQUI RED INSPECTIONS
This permit is issued subject to the regulations contained in the Erosion Control
Tigard Municipal Code, State of Ore. Specialty Codes and all other Grading Insp
applicable laws. All work will be done in accordance with Strm Drain Insp
approved plans. This permit will expire if work is not started San Sewer Insp
within 180 days of issuance, or if work is suspended for more Domestic water 1
than 180 days. ATTENTION: Oregon law requires you to follow rules Misc. Inspection
adopted by the Oregon Utility Notification Center. Those rules are Final Inspect ion
set forth in OAR 952-001 -0010 through OAR 952 -001 -0080. Your may
obtain copies of these rules or direct questions to OUNC by calling
(503)246 -9187.
•
Issued by: f ermittee Signature: L 1\ 4 4V1 143 ""-
+++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
Call 639 -4175 by 7:00 p.m. for an inspection needed the next business day
+++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
•
Pete") 7 -.'fR
Recd By
CITY OF TIGARD Site Permit Application Recd Rec'd 7 -/ 5 Date
13125 SW HALL BLVD. Commercial: Complete ENTIRE form Date to P.E. —ZO
TIGARD, OR 97223 Residence: Complete SHADED areas Date to DST 3 / l Or (503) 639 -4171 x304 Permit #G 'i - OF) 7
Related SWR #
Called 3 — 1/4 4 —
Print or Type
5P6 re Z c
x% -
Incomplete or illegible applications will not be accepted
Project Name ,, (Complete all that apply)
Job -- orn .Co
Address Address Storm Sewer
a7 (fl S cS w tAtA ti 4C0.ns' AYE. Linear Ft.
dame Sanitary Sewer
AN --rii ° r�os'ot... Linear Ft.
Owner Mailing Address Fresh Water
/ 2'7 (C S tclr! t,,i yfrt"<i v►S A Linear Ft.
City/State Zip Phone Catch Basins
17 6 rt.c > o rC 9 7u3 63 f - #
General IVIe Clean Outs
Contractor t o S 14 Ays #
Prior to permit Mailing Address Describe work to be done:
issuance, all l k A a 3 U / Y33 New❑ Addition❑ Alteration❑ Repair❑
copy of
licenses are .# f- /State / p Zip Phone Additional Description of Work:, /tain i
required if /v44A> 4 lam- /7016 6 52 -93x3
S tate Const. Cont. Board Lic. # E Date ✓A'�
expired in COT � �/ �� "it
xp.
database / / 32 g (p '9 Y 07,54,4((04J,,
Name ; Project
Valuation $ A / c 0O
Architect Mailing Address Plans Required: See Mat on back
The following, must accompany this application:
City /State Zip Phone - Site plan with Vicinity Map Parking (including
Showing ADA compliance ADA) & Lighting Plan
Name Grading Plan and details Landscaping Plan
Engineer Mailing Address Erosion Control Plan and Retaining Structures
details including calculations
City/State Zip Phone Site Utility Plan and details Soils Report
(showing connection to (if required)
approved system)
Excavation Volume I hereby acknowledge that I have read this application, that the
(Soils report required for >5,000 cu. Yards information given is correct, that I am the owner or authorized
cu. yds. agent of the owner, and that plans submitted are in compliance
with Oregon State laws.
Fill Volume Sigiall of Own /Agent Date
(Soils report required for >5,000 cu. Yds.) - /r` 96
cu. yds.
Will the fill support a structure C Pe n me Phone
(Engineer required if answer is yes) YESD NOD
dafelv'S /4 68? 9- 3
Retaining structure? (check one) ['Rock FOR OFFICE USE ONLY
❑ CMU Notes:
['Concrete e - - va 7 Vk al' �4 v`
['Other er
Total new impervious area including all Land Use Case # Ma /TL#
buildings, sidewalks, and paving Sq. Ft. /�1L / 3-C� 7 S 1
-n+eol
siteapp.doc 3/98
• :
COMMERCIAL PLAN SUBMITTAL
REQUIREMENT MATRIX
f- BOTH POPOA N 09
ii
P- 1 tig06iideiitiiktgAubtr o ::
submitta application For an electrical the application-rriti.O..tio the
Ian before Manr-T.e.v.ie*
s ignature • the supervising • •• • : .the.00lipootto.reqvpt .
• r olaf 1.6::•0400:*44(00..ri#::Ei4riiiner. : .
(Copy for cOhtrfotor
• plan set for purposes
addition t -
wAs
iiiiito6-cooty,
ViPE OF SUBMITTAL - - t T o t a l#of
:„,.. KEY:
-
• •:•'" Submitted,
• •• „„
S (Private) 1
S = Site Work
B (New or Add) 1 B = Building
F (New or Add or Alt) 3 F = Fire Protection System
M (New or Add or Alt) 1 M = Mechanical
B & M (New or Add) 1 P = Plumbing
B (New, Add, or Alt) 2 E = Electrical
B & M & P (New or Add) 2 New = New Building
E (New, Add, or Alt) 2 Add = Addition
B & F & M & P & E 3 Alt = Alternation to Existing
(New , Add) Building
• •
- )43,or
p.,(Ait)
--- .......
• ••. _ .
NOTES:
0 1 a . - -
* ShAdOiti:OreaS 0$.46t.o..
ALT 0 i tt 46 "o n • •
....,.,... :
lAdsts\maxtrixl.doc 07/06/98
CITY OF TIGARD_
DEVELOPMENT SERVICES
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
IMPORTANT PERMIT NOTICE
RE: Flan Check # 1
' DAN THOMPSON
12765 SW W ATK I NS
TIGARD OR 97223
•
Parcel.. 2S12I2BC —THPO1
Site Address: 12765 SW WATKINS AVE
Subdivision.: THOMPSON PARTITION
Block.......: Lot: 001 •
Jurisdiction: TIC •
Zoning ° R -4.5
Remarks:
Site and grading permit for minor land partition
This letter is to - confirm receipt of your Site -Work or Building permit appli—
cation which has been forwarded to the plans examiner tdday for review.
As a reminder, the associate land use case(s) is /are: PA 60'r
Please be aware you are responsible for satisfying the conditions of the land
use case(s) and must submit plans directly to the appropriate staff person(s)
indicated on your final order.
Your building plans ARE NOT rutted to the planning or engineering departments.
You must satisfy the Land use permit conditions independent of the building
permit plans review process.
After the building plans review process has been completed, your site work .or
building permit will NOT be issued 'without approval from the engineering and
planning departments.
If you have any questions regarding• this notice, please contact me directly at
639 -4171 for further clarification.
Sincerely,
•
/9 e'
Development Services Technician
cc: Building Department •
Planning Department
Engineering Department
f 1p R ? , r r ,.a ,. • 1 . 7 , •' • ., • _ .A •
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
/// erd:.Vg Requested 3 / /al f AM K PM BLD
Location /r-VA5 -- / ,r' i,,n2 D� Suite MEC
Contact Person Qirt� , - 461ZO"14..J Ph (37- 97/7 PLM
Contractor • Ph SWR
BUILDING Tenant/Owner ELC
■ ' Retaining Wall ELR
Footing Access: / �'
Foundation 6 / � G �41 N v — FPS
Ftg Drain SGN
Crawl Drain Inspection Notes: t o., - 7
Slab � ,�L �i �rCI�XJ . SIT 9,'4
Post & Beam i' /�0
Ext Sheath /Shear U7
Int Sheath /Shear
Framing .
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof }�
`'
__ Misc � -
Final = — /; - , '` - - « i
PASS , PART FAIL / - f r
PLUMBING / � l✓
Post & Beam
Under Slab � - �_ i Top Out Water Service ,l
Sanitary Sewer f �
` %
Rain Drains i--.1
Final 6-- / /
PASS PART FAIL
MECHANICAL
Post & Beam
Rough In
Gas Line
Smoke Dampers �`�
Final _
PASS PART FAIL 1
ELECTRICAL
Service
Rough In
UG /Slab I
Low Voltage
Fire Alarm
Final
PASS' PART FAIL '
‹
Backfill /Grading
Sanitary Sewer
Stormbrain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access
ADA
Approach /Sidewalk Dat
• e r D 77.1 r Inspector0 Ext
='i. PART FAIL DO NOT REMOVE this inspection record from the job site.